Central Line

This article defines Central Lines to make sure we use the same definition in

• Iatrogenic, infection, central venous catheter-related bloodstream infection (CVC-BSI, CLI)
• QA Infection CLI
• Central Line Count

and by the following for venous lines

• Central Venous Catheter at 2300 (TISS Item)
• Central venous catheter (TISS Item)

CL means Central Line

• A CL is a vascular access catheter that passes through or has a tip ending in one of the great vessels.
• It may be used for infusion, blood sampling, or hemodynamic monitoring.
• It can be temporary, or long-term/permanent.

Great vessels include:

• aorta
• pulmonary artery
• superior vena cava
• inferior vena cava
• brachiocephalic veins
• internal jugular veins
• subclavian veins
• external iliac veins
• common iliac veins
• femoral veins

Central Lines include:

• subclavian vein catheter
• internal jugular vein catheter
• PICC (Peripherally Inserted Central Catheter)
• Swan-Ganz (pulmonary artery) catheter
• Broviac
• Groshong
• Hickman
• hemodialysis catheter (e.g. Vascath)
• implanted ports (e.g. Port-a-cath)
• central line introducer -- i.e. even if it does not have a central line in it
• introducer for a temporary pacing wire

Not counted as Central Lines:

• arterial catheters inserted into an artery
• ECMO
• IABP
• VAD; IMPELLA
• A-V fistula
• regular peripheral IVs
• any intravascular device that does not have a lumen (e.g. pacemaker wires)

Code peripheral PICC lines

Kendiss Olafson confirmed that PICC lines that are noted on x-ray to be peripheral are still to be coded in our TISS as a central line. They still carry the same implications for nursing workload and have the same risk for infection, so for purposes of TISS and CL-BSI counting, these PICCs should be treated as central.--Michelle Lagadi--2015 September 16.

what are included

Do central lines include the following: implantable-ports, non tunneled TLC, Swan Ganz catheter, tunneld-Borviac, Groshong, Quinton, Hickman, ASHE catheter, PICC lines? If yes would they be counted in the central line days for that unit?

1. • Yes to all of the above if they meet the definition. Central lines are not defined by the type of device.

• That answer seems to go directly against the definition in here... can we get rid of it?

1. Is a dialysis catheter considered a central line since it isn't used for infusion?
   • A dialysis catheter is considered a central line if it meets the definition of a central line. It is used for infusion of the patient's own blood.

Frequently asked questions

Template:Discussion This info would be better off integrated properly into the definitions above... Ttenbergen 20:07, 2017 September 12 (CDT)

1. If a patient in an ICU has a temporary or tunneled hemodialysis catheter, is that device counted as a Central Line in the central line days?
   • If a line meets the defintion of what is a central line, then it should be counted. The only exception to this would be an implanted device that is not used. In this situation, the line would only be counted beginning on the first day that it is accessed (e.g., physician orders that the port-a-cath be flushed). Then it would be counted every day there after.

• that info about actual use needs to be integrated above. Or does it not? Is that only for Central Line Counts or part of the definition when to consider a Central Line in general? Ttenbergen 20:07, 2017 September 12 (CDT)